Organization Active NPI

Marin Matheus and Associates, LLC

  • Community/Behavioral Health Agency
  • Dunwoody, GA
National Provider Identifier
1104396811
Registry record updated Nov 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
MARIN MATHEUS AND ASSOCIATES, LLC
Practice address
2050 Beaumont LN
Dunwoody, GA 30338-4500
Phone
(404) 434-1267
NPI assigned
Nov 26, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Marianela Matheus, M.ED., LPC, CPCS,RPTNPI 1114136603
Title
Member Vicepresident
Phone
(404) 434-1267

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2050 Beaumont LN
Dunwoody, GA 30338-4500

Mailing address

2050 Beaumont LN
Dunwoody, GA 30338-4500

Other identifiers 1

IdentifierTypeStateIssuer
003200881AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260511000688 GA Part B Supplier - Clinic/Group Practice 1557839321 Receives reassigned benefits from 1 practitioner
Practice locations: Atlanta, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543190400000",
    "number": "1104396811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 BEAUMONT LN",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303384500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 BEAUMONT LN",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303384500",
            "telephone_number": "404-434-1267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIN MATHEUS AND ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-26",
        "last_updated": "2018-11-26",
        "status": "A",
        "authorized_official_last_name": "MATHEUS",
        "authorized_official_first_name": "MARIANELA",
        "authorized_official_title_or_position": "MEMBER VICEPRESIDENT",
        "authorized_official_telephone_number": "404-434-1267",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.ED., LPC, CPCS,RPT"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003200881A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunwoody, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.